meronk blepharoplasty

For comprehenisve information on
Asian double eyelid surgery and
crease blepharoplasty, see

Asian Eyelid Surgery Resource

Men and women of Asian heritage seek blepharoplasty eyelid surgery for the same basic reason as their Occidental counterparts, namely, to enhance the appearance of the existing eyelid structure so that it conforms to widely-accepted standards of aesthetics and balance. Not only is blepharoplasty the most requested cosmetic operation in the Asian population, but the typical age at which Asian patients request eyelid surgery is younger.

Irrespective of ethnicity, what constitutes an attractive eyelid?  

An upper eyelid is generally considered attractive if it lacks excessive skin and fat, possesses a reasonably well-defined crease (which makes the eye look bigger), and displays at least some platform of exposed skin between the crease and the eyelashes.

A well-contoured lower eyelid free of bulging fat projects an image of youth, energy, and rest.

Most experienced eyelid surgeons agree that the desirability of such qualities is uniform across many diverse cultures and is not simply a matter of "Western bias."

How do Asian and Occidental eyelids differ?  

Compared to the Occidental upper eyelid, the Asian upper eyelid crease forms closer to the eyelashes, is not as deep, and is often poorly defined or broken into multiple folds. In about half of Asian people, the crease is entirely absent. Asian blepharoplasty helps to create what is sometimes called a double eyelid, a term that refers to a lid segmented into two visible parts by a noticeable fold.

The Asian eyelid may appear relatively puffy due to the downward extension of normal fat much closer to the lashes. The fat pad just below the eyebrow (retro-orbicularis oculi fat, or ROOF) is often thicker and located in a lower position.

The skin of the Asian upper eyelid tends to grow baggier at an earlier age.

A tiny crescent of skin, or epicanthal fold, may exist between the eyelid corner and the nose. The eyelid crease, when present, may appear to dive down and blend into it.

Because the eyelashes of the less-creased Asian eyelid can bend downward, the opening between the upper and lower eyelids may appear partially obstructed.

These differences between Asian and Occidental eyelids are determined by the various ways in which the eight distinct layers of the lid attach to or interact with one another. Of paramount importance is the absence of fibrous extensions from the deeper levator muscle (opening muscle) to the more superficial pre-tarsal orbicularis muscle (part of the closing muscle located just beneath the skin), which, in the Occidental eyelid, blocks fat from entering the lower part of the lid and creates a skin indentation (crease) when the eye is opened.

Just as there are fundamental differences between Asian and Occidental eyelids, there are also distinct anatomical differences between and within the many subgroups of Asian heritage (Japanese, Chinese, Korean, and so on) as well as differences introduced by the blending of subgroups through intermarriage. A surgeon must be well-versed in eyelid anatomy and be able to recognize subtle variations so that the operation may be adjusted accordingly.

Pre-operative considerations in Asian blepharoplasty  

To avoid an inappropriate or unexpected result, the surgical steps in Asian blepharoplasty must be planned to take into account such anatomical variations (starting point) as well as the particular desires of each individual patient (ending point).

Men and women vary in their relative concerns about altering specific eyelid features. For instance, women often request a higher eyelid crease (which helps in the application of makeup).

Some patients may be seeking minimal change, while others may request a moderate or even somewhat aggressive approach.

While most younger patients desire the creation of a defined and higher crease, some older Asian patients may wish only to restore the youthful appearance of the eyelid without noticeably altering any basic ethnic characteristics.

Attempting to achieve a radical transformation of the basic pre-existing anatomy, however, is generally unwise and may result in eyelids that look unnatural or seem mismatched to the rest of the face.

As with Occidental cosmetic eyelid surgery, Asian blepharoplasty is not a single operation, and no all-purpose technique is suitable in every instance.

Asian Blepharoplasty Photos

Asian Eyelid Surgery Resource
An in-depth reference on Asian Eyelid Surgery

From the Insider's Guide to Blepharoplasty:
Chapter 14: Asian upper eyelid blepharoplasty (surgery details)
Chapter 28: Risks and complications of blepharoplasty

eyelid surgery resource
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